Propafenone: Difference between revisions
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==Special Populations== | ==Special Populations== | ||
===[[Drug pregnancy categories|Pregnancy Rating]]=== | ===[[Drug pregnancy categories|Pregnancy Rating]]=== | ||
* | *No assigned FDA category | ||
*No associated risk of miscarriage, birth defects, or adverse maternal or fetal outcomes with this drug | |||
===Lactation risk=== | ===Lactation risk=== | ||
* | *Dosages up to 900mg/day not expected to cause adverse effects in breast fed infants | ||
===Renal Dosing=== | ===Renal Dosing=== | ||
*Adult: | *Adult: No dosage adjustment needed | ||
*Pediatric: | *Pediatric: No dosage adjustment needed | ||
===Hepatic Dosing=== | ===Hepatic Dosing=== | ||
*Adult: | *Adult: Administer 20-30% of normal IR dose and monitor closely; consider dose reduction if administering ER dose | ||
*Pediatric: | *Pediatric: No specified guidelines | ||
==Contraindications== | ==Contraindications== | ||
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*SLE | *SLE | ||
==Adverse Reactions== | ==Adverse Reactions<ref>Drugs.com. 2021. Propafenone (Professional Patient Advice) - Drugs.com. [online] Available at: <https://www.drugs.com/ppa/propafenone.html> [Accessed 25 June 2021]</ref>== | ||
===Serious=== | ===Serious=== | ||
* Cardiac arrhythmia (2%-10%; new or worsened) | |||
* Cardiac failure (1%-4%) | |||
===Common=== | ===Common=== | ||
* Unusual Taste (3%-23%) | |||
* Dizziness (4%-15%) | |||
* Nausea/Vomiting (<11%) | |||
==Pharmacology<ref>Drugs.com. 2021. Propafenone (Professional Patient Advice) - Drugs.com. [online] Available at: <https://www.drugs.com/ppa/propafenone.html> [Accessed 25 June 2021]</ref>== | |||
*Half-life: Extensive metabolizers: 2-10 hours; Poor metabolizers: 10-32 hours | |||
*Metabolism: Hepatic via CYP2D6, CYP3A4 and CYP1A2 | |||
*Excretion: Urine (<1% unchanged; remainder as glucuronide or sulfate conjugates); feces | |||
==Mechanism of Action<ref>Drugs.com. 2021. Propafenone (Professional Patient Advice) - Drugs.com. [online] Available at: <https://www.drugs.com/ppa/propafenone.html> [Accessed 25 June 2021]</ref>== | |||
*Class 1c antiarrhythmic agent w/ local anesthetic properties | |||
*Blocks the fast inward sodium current, slowing the rate of increase of the action potential. | |||
*Prolongs conduction/refractoriness in myocardium, reduces spontaneous automaticity, and exhibits some beta-blockade activity | |||
==Mechanism of Action | |||
==Comments== | ==Comments== | ||
Latest revision as of 16:44, 25 June 2021
Administration
- Type:Antiarrhythmics
- Dosage Forms: Oral cap, Oral tablet
- Routes of Administration: PO
- Common Trade Names: Rhythmol
Adult Dosing
Sustained Ventricular Tachycardia
- 150 mg PO q 8 hrs
- Dosage may be increased at 3-4 days to 225 mg PO q 8 hrs
- Max dosage: 300 mg PO q 8 hrs
New Onset Atrial fibrillation
- 450 to 600 mg PO as a single dose
Sinus Rhythm Maintenance in Atrial fibrillation or Atrial flutter
- See sustained VT dosing
PSVT Prophylaxis in AVRT including WPW
- 300 mg q 8 hrs for 48 hrs (max 900 mg q 8 hrs)
- Limited data regarding dosing
Pediatric Dosing
PSVT Prophylaxis in AVRT including WPW
- 8 to 10 mg/kg/day PO in 3 divided doses.
- Increase by 2 to 3 mg/kg/day every 2 to 3 days
- Max 15 mg/kg/day PO in 3 divided doses.
Special Populations
Pregnancy Rating
- No assigned FDA category
- No associated risk of miscarriage, birth defects, or adverse maternal or fetal outcomes with this drug
Lactation risk
- Dosages up to 900mg/day not expected to cause adverse effects in breast fed infants
Renal Dosing
- Adult: No dosage adjustment needed
- Pediatric: No dosage adjustment needed
Hepatic Dosing
- Adult: Administer 20-30% of normal IR dose and monitor closely; consider dose reduction if administering ER dose
- Pediatric: No specified guidelines
Contraindications
- Allergy to class/drug
- Significant QRS widening
- High Grade Heart Block
- Heart Failure
- Left Ventricular Dysfunction
- Bradycardia
- Cardiogenic Shock
- Electrolyte Imbalance
- Hypotension
- Sick Sinus Syndrome
- Long QT Syndrome
- Brugada Syndrome
- Renal failure (relative)
- Hepatic failure (relative)
- Asthma
- COPD
- Bronchospasm
- SLE
Adverse Reactions[1]
Serious
- Cardiac arrhythmia (2%-10%; new or worsened)
- Cardiac failure (1%-4%)
Common
- Unusual Taste (3%-23%)
- Dizziness (4%-15%)
- Nausea/Vomiting (<11%)
Pharmacology[2]
- Half-life: Extensive metabolizers: 2-10 hours; Poor metabolizers: 10-32 hours
- Metabolism: Hepatic via CYP2D6, CYP3A4 and CYP1A2
- Excretion: Urine (<1% unchanged; remainder as glucuronide or sulfate conjugates); feces
Mechanism of Action[3]
- Class 1c antiarrhythmic agent w/ local anesthetic properties
- Blocks the fast inward sodium current, slowing the rate of increase of the action potential.
- Prolongs conduction/refractoriness in myocardium, reduces spontaneous automaticity, and exhibits some beta-blockade activity
Comments
See Also
References
- ↑ Drugs.com. 2021. Propafenone (Professional Patient Advice) - Drugs.com. [online] Available at: <https://www.drugs.com/ppa/propafenone.html> [Accessed 25 June 2021]
- ↑ Drugs.com. 2021. Propafenone (Professional Patient Advice) - Drugs.com. [online] Available at: <https://www.drugs.com/ppa/propafenone.html> [Accessed 25 June 2021]
- ↑ Drugs.com. 2021. Propafenone (Professional Patient Advice) - Drugs.com. [online] Available at: <https://www.drugs.com/ppa/propafenone.html> [Accessed 25 June 2021]